Abstract
Congenital paraesophageal hernia is rare in infants and children. Most reported cases are acquired resulting as a complication following Nissen’s fundoplication for gastroesophageal reflux. By definition, paraesophageal hernia occurs when the stomach protrudes laterally through the esophageal hiatus toward the chest while the gastroesophageal junction remains in its normal anatomic position. This however is not the case in the pediatric age group where in most of cases the whole stomach herniates into the thoracic cavity with the gastroesophageal junction lying in the chest. These may represent a combined type of sliding and paraesophageal hernias, or in the pediatric age group congenital paraesophageal hernia is distinct and different from their adult counterpart. Another distinguishing feature of pediatric paraesophageal hernia is that it is not uncommon for other intra-abdominal organs to herniate into the chest through the hiatal opening. Complications are more prevalent in paraesophageal hernias than in sliding hiatus hernias.
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